Effects of mindfulness-based interventions (MBIs) on psychological outcomes and HbA1C in patients with diabetes: A systematic review and meta-analysis of randomized controlled trials.
Chuntana Reangsing, Sasinun Punsuwun, Khanittha Pitchalard, Sarah Oerther
Diabetes Research and Clinical Practice May 1, 2026 DOI: 10.1016/j.diabres.2026.113322 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 1,987 |
| Population | Individuals with diabetes mellitus, mean age ranging from 18.3 to 66.3 years |
| Intervention | Mindfulness-based interventions |
| Topics | Meditation |
| Key findings | Across 24 primary studies, mindfulness-based interventions improved HbA1c (g = 0.564), stress (g = 1.132), anxiety (g = 1.321), and depression (g = 1.059) in people with diabetes. The authors report that intervention format, intention-to-treat analysis, concealed allocation, attrition, funding sources, and a priori analysis modified effect sizes, and they call for future studies with robust designs. |
Abstract
We synthesized the effects of MBIs on psychological outcomes and HbA1c in diabetic patients and conducted subgroup analyses to investigate the sources of heterogeneity. Nine electronic databases were methodically explored from their inception through May 2025. We reviewed studies on the outcomes for individuals with diabetes mellitus who participated in mindfulness-based interventions. A random-effects model was employed to calculate the effect size. The funnel plot, Q statistics, and I2 were employed to assess heterogeneity among studies. Across 24 primary studies (N = 1987), 942 participants engaged in mindfulness-based interventions and 955 functioning as controls. Mean age ranged from 18.3 to 66.3 years. Overall, mindfulness-based interventions showed improvement of HbA1c (Hedges' g = 0.564, 95%Confidence interval, CI, 0.221, 0.908, p = 0.001), stress (g = 1.132, 95%CI 0.551, 1.714, p < 0.001), anxiety (g = 1.321, 95%CI 0.569, 2.072, p = 0.001) and depression (g = 1.059, 95%CI 0.564, 1.555, p < 0.001). MBI format, intention-to-treat analysis, concealed allocation, attrition, funding sources, and a priori analysis were modifiers affecting the effect size. To sum up, mindfulness-based therapies markedly improved HbA1c levels and psychological outcomes, among individuals with diabetes mellitus. Future studies with robust designs are warranted. Healthcare professionals may consider using these therapies to improve psychological outcomes and HbA1c levels in individuals with diabetes mellitus.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cites 8
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Mindfulness-based interventions for adults with type 2 diabetes mellitus: A systematic review and meta-analysis. Integrative Medicine Research June 1, 2025
- A blended mindfulness-based stress reduction program to improve diabetes self-management among people with type 2 diabetes mellitus: a mediation effect analysis. Annals of Behavioral Medicine January 4, 2025
- Managing type 2 diabetes and depression with Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) Discover Psychology December 1, 2022
and 3 more in the library